Provider Demographics
NPI:1952349755
Name:MARON, BARRY RALPH (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:RALPH
Last Name:MARON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7125 TICONDEROGA RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-5041
Mailing Address - Country:US
Mailing Address - Phone:505-821-7936
Mailing Address - Fax:505-796-0402
Practice Address - Street 1:927 SAN PEDRO DR SE STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-4981
Practice Address - Country:US
Practice Address - Phone:505-265-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM71177207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery